A journal as a mirror of continued progress in internal medicine. A century of Polish Archives of Internal Medicine.

Internal medicine emerged as a new medical specialty in the second half of the 19th century. It was based on a novel diagnostic and therapeutic paradigm, and included pathophysiologic interpretation of physical examination, laboratory tests, and imaging techniques, in contrast with previous descriptive approach to clinical problems. Professor Edward J. Sas-Korczynski in 1891 proposed to organize Polish meetings on internal medicine. The proposal was implemented only in 1906 by Antoni W. Gluzinski, a famous Polish internist. Despite obstacles set by the partitioning powers, the Society of Internists of the Polish Lands was founded. The name of the association was changed to the Polish Society of Internal Medicine during the congress held in Vilna (now Vilnius) in 1923, the first one organized in the independent Poland. The journal of the Society, Polish Archives of Internal Medicine, was founded and Antoni W. Gluzinski was its first editor-in-chief. Later, the journal was edited by Wladyslaw Janowski, Witold E. Orlowski, Andrzej Biernacki, Tadeusz Orlowski, Artur Czyzyk, and Anetta Undas. Witold E. Orlowski was a father of modern Polish internal medicine, and contributed to the development of its subspecialties and their societies. Most of them had roots in the specialist sections of the Polish Society of Internal Medicine. The journal supported the newly founded societies by publication of issues focused on selected subspecialties. Despite the development of subspecialties, the role of internal medicine as a holistic discipline covering the diagnosis and therapy of many organs does not decrease.

[200 years of history of National clinic of internal diseases: issues of periodization (stages 1-3)].

The main development of the clinical internal medicine in Russia took place over the past 200 years. To understand the pattern of this process, we explored its possible subdivision into phases (periods). This article presents the first part of the proposed periodization describing the characteristics and time frame of the first three stages (from the beginning of the 19th century to the late 1910s).

[Exploration on two methods of waiting for qi in needle insertion and withdrawal of acupuncture reinforcing and reducing technique recorded in Neijing (The Yellow Emperor's Classic of Internal Medicine)].

The reinforcing and reducing technique based on the speed of needle insertion and withdrawal is the important acupuncture technique recorded in Neijing (The Yellow Emperor's Classic of Internal Medicine). Regarding the speed of needle insertion and withdrawal, the timing of needle insertion and withdrawal is one of the key factors to judge the therapeutic effects. In the paper, the origin was studied on the two methods of waiting for qi recorded in Neijing (The Yellow Emperor's Classic of Internal Medicine), e.g. "waiting for respiratory qi" and "waiting for qi beneath needle"; and its application progression and clinical significance were explained. Of them, the "waiting for qi beneath needle" is mostly used to decide the timing of needle withdrawal and closely related to the therapeutic effects of reinforcing and reducing technique; and its application is fully developed in later generations. In Nanjing (Treaties on Difficult Questions), it stresses the needle insertion after waiting for qi with the assistant hand, lifting and thrusting manipulation is followed after arrival of qi beneath needle. This technique brings the impacts on the reinforcing and reducing technique of acupuncture in later generations.

["On a strictly scientific basis." German constitutional medicine establishing itself, 1911­1921]. / "Auf strengster wissenschaftlicher Grundlage." Die Etablierungsphase der modernen Konstitutionslehre 1911 bis 1921.

In the years between 1911 and 1921, modern constitutional medicine established itself as an interdisciplinary research program in German-speaking countries. Untouched by later holistic interpretations and still far from the ,,crisis of medicine" of the late 1920s early constitutional medicine was very attractive due to its scientific self-characterisation. Thus, it became influential across the medical disciplines. This paper examines history and subject matter of German modern constitutional medicine in its first decade, starting in 1911, the year constitutional medicine was first publicly discussed by the Wiesbaden congress for internal medicine, including its development during World War I and closing with the first textbooks for medical students in 1921.

[Medical anthropology in academies: on the criticism of natural science medicine exemplified by Viktor von Weizsäcker]. / Medizinische Anthropologie in Akademien: Zur Kritik der naturwissenschaftlichen Medizin am Beispiel Viktor von Weizsäckers.

Viktor von Weizsäcker (1886-1957) founded his concept of medical anthropology as a clinician educated in internal medicine and neurology. He tried to broaden natural scientific medicine psychosomatically focussing on the "sick human". The natural scientific approach would exclude subjectivity, and therefore he propagated the "introduction of the subject' (Einführung des Subjekts) into the life sciences. His own sensory physiological experiments and Sigmund Freud's psychoanalysis inspired him essentially since the 1920s. In his main work Der Gestaltkreis (gestalt circle) published in 1940 he stressed the "entity of perceiving and moving" (Einheit von Wahrnehmen und Bewegen) in regard to relevant aspects of medicine. In 1932, Weizsäcker became a member of the Heidelberg Academy of Sciences, whose president he was from 1947 till 1949; 1942 he became a member of the Leopoldina. Primarily his merits as a neurologist were highly appreciated. His medical anthropology was not relevant for his election by the two academies. Nevertheless, there was a certain repudiation against the objectivistic and materialistic Weltanschauung within the scientific community. So, Paracelsus and Goethe were highly estimated as natural philosophical guides for own conceptions. This was especially evident for the circle around Wilhelm Troll and Karl Lothar Wolf in Halle, both members of the Leopoldina, who were fascinated by Goethe's concept of "Gestalt". Weizsäcker's lecture on "Gestalt und Zeit" in Halle in 1942 fitted in the concept of those natural scientists.

Contributions of Ibn Al-Nafis (1210-1288 AD) to the progress of medicine and urology. A study and translations from his medical works.

This primary-source study of 4 medical works of the 13th century Muslim scholar Ibn Al-Nafis confirmed that his Kitab Al-Mujaz Fi Al-Tibb was authored as an independent book meant to be a handbook for medical students and practitioners not as an epitome of Kitab Al-Qanun of Ibn Sina as thought by recent historians. His huge medical encyclopedia, Al-Shamil, represents a wave of intense scientific activity that spread among the scholars of Cairo and Damascus following the massive destruction of books by Hulako's Army during the devastation of Baghdad in 1258. Like his predecessors in the Islamic Era, Ibn Al-Nafis critically appraised the views of scholars before him in the light of his own experimentation and direct observations. Accordingly, in his books Sharh Tashreeh Al-Qanun, Risalat al-Aadaa and Al-Risalah Al-Kameleyyah, we find the first description of the coronary vessels and the true concept of the blood supply of the heart as well as the correct description of the pulmonary circulation and the beginnings of the proper understanding of the systemic circulation. Those discoveries of Ibn Al-Nafis, translated to Latin by Andreas Alpagus printed in Venice in 1547, appeared, 6 years later, in the Christianismi Restituto of Servetus and, in 1555, in the De Fabrica Humani Corporis of Vesalius 2nd edition then in the works of Valvarde 1554, Columbus 1559, Cesalpino 1571, and finally Harvey in 1628. Furthermore, this study documented several other contributions of Ibn Al-Nafis to the progress of human functional anatomy and to advances in medical and surgical practice.

[What is Internal Medicine?]. / Qué es Medicina Interna?

Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems) and the prevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal training in a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to be considerably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies) and the patients' tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider a greater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards.

Contributions of Muhadhdhab Al-Deen Al-Baghdadi to the progress of medicine and urology. A study and translations from his book Al-Mukhtar.

This study of the Arabic 4-volume book of Al-Mukhtar Fi Al-Tibb (Choice Book on Medicine) written by the Muslim physician Muhadhdhab Al-Deen Al-Baghdadi (515-610 H, 1117-1213 AD) aimed at evaluating his contributions to the progress of medicine and urology along with providing English translations of relevant excerpts. Al-Baghdadi laid emphasis on the morals of medical practice and the principles of medical education describing how to select medical students and how to evaluate graduates. He stressed on the need for a long training program directly supervised by skilled expert doctors both in hospitals (Al-Bimaristanat) and during home visits. A good part of volume 1 was allocated to preventive medicine and the whole of volume 2 was devoted to the pharmacy section, which he restricted to what was proven by the experience of his teacher and by his own experiments. Same as all his predecessors in the Islamic era, Al-Baghdadi stressed the importance of clinical medicine and gave more details related to history taking, physical examination, differential diagnosis and prognosis. Similar to them, he also, emphasized that a doctor should be quite knowledgeable in anatomy. Furthermore, the presence of anatomical drawings in Kitab Al-Mukhtar Fi Al-Tibb is a further step forward in illustrating medical text books; a trend that flourished in the Islamic era reflecting the role of direct observations and experience. The detailed description of the functional anatomy of the uretero-vesical junction and the antireflux and micturition mechanisms given by Al-Baghdadi is contrary to that of Galen (130-200 AD) but conforms well to our contemporary understanding. In the conservative management of urinary stones, he described 70 simple and 13 compound drugs while those described by Pulus of Aegina (625-690 AD) were only 20 simple and 3 compound drugs. Furthermore, Al-Baghdadi's description of the instruments and techniques of urethral catheterization, perineal cystolithotomy and perineal cystolithotripsy using Al-Zahrawi's lithotrite is meticulous and reveals originality, dexterity and experience.

¿Qué es Medicina Interna? / What is Internal Medicine?

Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems) and theprevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal trainingin a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to beconsiderably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies) and thepatients’ tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider agreater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards. (AU)

¿Qué es Medicina Interna? / What is Internal Medicine?

Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems) and the prevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal training in a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to be considerably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies) and the patients' tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider a greater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards.

[Internal medicine: challenges and opportunities at the beginning of a new century]. / La Medicina Interna: retos y oportunidades al inicio de un nuevo siglo.

Internal medicine was born at the end of the nineteenth century as the result of the great amount of medical knowledge that accrued. The word "internal" has a great meaning and symbolism that underscores a holistic view of the patient. After some years of fruitful work, internal medicine experienced the appearance of subspecialties. This meant a great technological advance but increased the costs of services and deteriorated patient-physician relationship. These tactics along with world sanitary changes, offer a unique opportunity for the resurgence of Internal Medicine. Nowadays the internist has the image of an expert able to treat patients with diseases that involve several organs or systems or to serve as a consultant for complex medical problems. The new threats of the specialty are Family Medicine and hospital physicians. The areas in which the internist should acquire expertise to cope with the new sanitary requirements are also analyzed.

La Medicina Interna: retos y oportunidades al inicio de un nuevo siglo / Internal medicine: challenges and opportunities at the beginning of a new century

Internal medicine was born at the end of the nineteenth century as the result of the great amount of medical knowledge that accrued. The word "internal" has a great meaning and symbolism that underscores a holistic view of the patient. After some years of fruitful work, internal medicine experienced the appearance of subspecialties. This meant a great technological advance but increased the costs of services and deteriorated patient-physician relationship. These tactics along with world sanitary changes, offer a unique opportunity for the resurgence of Internal Medicine. Nowadays the internist has the image of an expert able to treat patients with diseases that involve several organs or systems or to serve as a consultant for complex medical problems. The new threats of the specialty are Family Medicine and hospital physicians. The areas in which the internist should acquire expertise to cope with the new sanitary requirements are also analyzed.